ABSTRACT
To assess the effectiveness of remote clinical quality management of endovascular Aim care. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008-2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019-2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The Methods system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019-2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p<=0.005. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In April-December 2020 it increased up to 71.6% (p<0.001). The frequency of performing Results PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005). Remote clinical management based on telemedicine and mentoring process Conclusion technologies contributes to improving the quality of endovascular care in MI.Copyright © 2021 Angles. All rights reserved.
ABSTRACT
The objective: to define hemogram parameters in smokers with COVID-19 and acute coronary syndrome when they are admitted to hospital. Subjects and Methods. 62 male smokers hospitalized due to acute coronary syndrome (ACS) were enrolled into a case-control study. Group 1 (n = 31) had ASC and COVID-19, Group 2 (n = 31) had ACS and no COVID-19. The groups were adjusted by age, body mass index and the date of hospitalisation. According to the current routing procedures, from September to December 2020, the subjects were referred to different hospitals in Sverdlovsk Region depending on COVID-19 status. Inpatient medical records were used to collect the data. Blood parameters were examined by Mindray BC-5150 (China) automatic hematological analyzer performing complete clinical blood count and differentiating 5 leukocyte subpopulations. Statistical processing was performed using Statistica 13.0. The significance of differences was taken at p < 0.05. Results. Smoking men with COVID-19 and ACS unlike those GOVID-19 negative had a lower level of diastolic blood pressure, significantly more often were diagnosed with low degrees of hypertension, higher BPD with the same frequency of detection and functional characteristics of chronic heart failure and chronic obstructive pulmonary disease. The hemogram showed a lower level of the number of leukocytes, the percentage of neutrophils, erythrocytes, hemoglobin, hematocrit, the average concentration of hemoglobin in the erythrocyte;a higher level of monocytes, erythrocyte sedimentation rate, and average platelet volume. The above changes can be associated with spesific features of the COVID-19 course. © 2022 New Terra Publishing House. All rights reserved.
ABSTRACT
To assess the effectiveness of remote clinical quality management of endovascular Aim care. The system of clinical quality management of medical care in myocardial infarction (MI) including the quality of remote control of endovascular care was developed and introduced into the health care system of the Moscow Region as a part of the comprehensive study in 2008–2020. The number of people under the study was 8375. The ground for assessing the effectiveness of remote clinical management in 2019–2020 was the health care system of megapolis. Based on the analysis of 2966 endovascular procedures protocols, the treatment tactics effectiveness of intraoperative decisions was studied after an emergency coronary angiography (ECA) had been performed by interventional cardiologists. The Methods system of remote clinical quality management of endovascular care included a complex of audiovisual communications, computer system processes, mentoring and the algorithm for making an intraoperative decision. The effectiveness of remote clinical quality management of endovascular care was investigated on the number of percutaneous coronary interventions (PCI) in MI, mortality of patients with MI in the Regional vascular center in 2019–2020. The T-criteria was used to assess the reliability. The material statistical processing was carried out in the Statistica 6.0 package calculating adequate statistical indicators and their reliability at p≤0.005. Ratio PCI/ECA in 2019, January-March 2020 counted up to 48.95%. In April-December 2020 it increased up to 71.6% (p<0.001). The frequency of performing Results PCI increased by 1.46 times (p<0.001). Hospital mortality from MI decreased during the following period 2019, April-December 2020 from 9.7% to 8.2% (p = 0.005). Remote clinical management based on telemedicine and mentoring process Conclusion technologies contributes to improving the quality of endovascular care in MI. © 2021 Angles. All rights reserved.